title: Working memory in children with cochlear implants: problems are in storage, not processing.
abstract: BACKGROUND
  There is growing consensus that hearing loss and consequent amplification likely interact with cognitive systems. A phenomenon often examined in regards to these potential interactions is working memory, modeled as consisting of one component responsible for storage of information and another component responsible for processing of that information. Signal degradation associated with cochlear implants should selectively inhibit storage without affecting processing. This study examined two hypotheses: (1) A single task can be used to measure storage and processing in working memory, with recall accuracy indexing storage and rate of recall indexing processing; (2) Storage is negatively impacted for children with CIs, but not processing.
  
  
  METHODS
  Two experiments were conducted. Experiment 1 included adults and children, 8 and 6 years of age, with NH. Procedures tested the prediction that accuracy of recall could index storage and rate of recall could index processing. Both measures were obtained during a serial-recall task using word lists designed to manipulate storage and processing demands independently: non-rhyming nouns were the standard condition; rhyming nouns were predicted to diminish storage capacity; and non-rhyming adjectives were predicted to increase processing load. Experiment 2 included 98 8-year-olds, 48 with NH and 50 with CIs, in the same serial-recall task using the non-rhyming and rhyming nouns.
  
  
  RESULTS
  Experiment 1 showed that recall accuracy was poorest for the rhyming nouns and rate of recall was slowest for the non-rhyming adjectives, demonstrating that storage and processing can be indexed separately within a single task. In Experiment 2, children with CIs showed less accurate recall of serial order than children with NH, but rate of recall did not differ. Recall accuracy and rate of recall were not correlated in either experiment, reflecting independence of these mechanisms.
  
  
  CONCLUSIONS
  It is possible to measure the operations of storage and processing mechanisms in working memory in a single task, and only storage is impaired for children with CIs. These findings suggest that research and clinical efforts should focus on enhancing the saliency of representation for children with CIs. Direct instruction of syntax and semantics could facilitate storage in real-world working memory tasks.
authors.affiliation: The Ohio State University, United States. Electronic address: nittrouer.1@osu.edu.
authors.forename: Susan
authors.initials: S
authors.lastname: Nittrouer
authors.forename: Amanda
authors.initials: A
authors.lastname: Caldwell-Tarr
authors.forename: Joanna H
authors.initials: JH
authors.lastname: Lowenstein
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001299:Audiometry / Q000379:methods; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000009:adverse effects / Q000379:methods; D003054:Cochlear Implants; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008569:Memory Disorders / Q000145:classification* / Q000209:etiology* / Q000503:physiopathology; D008570:Memory, Short-Term; D011939:Mental Recall / Q000502:physiology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D055815:Young Adult
keywords: Children; Cochlear implants; Cognition; Development; Hearing; Working memory